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City of Santa Ana <br />..:T Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />C ~~o ~ <br />.................................. ............................ _................................. <br />COTC Office Use Only <br />Revised 07-22-09 <br />Please complete this form when the attached agreement and all amendments (if any`, '" `~^~ ~ ~ ifs ~' ~9 <br />are no longer in effect. <br />:; <br />Return form to the Clerk of the Council Office (M-30). ~ ~ - A <br />{R" ; ." <br />to ._. <br />The agreement with <br />l~ <br />( / <br />No. 1 v ' ~p~ ' ~/ ~3 was completed on ~~ ~ V 1 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: ~ ~/ <br />Phone/Ext.: <br />Signature: <br />Date: <br />